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Related to Involuntary Euthanasia: passive euthanasia, active euthanasia


(yo͞o'thənā`zhə), either painlessly putting to death or failing to prevent death from natural causes in cases of terminal illness or irreversible coma. The term comes from the Greek expression for "good death." Technological advances in medicine have made it possible to prolong life in patients with no hope of recovery, and the term negative euthanasia has arisen to classify the practice of withholding or withdrawing extraordinary means (e.g., intravenous feeding, respirators, and artificial kidney machines) to preserve life. Accordingly, the term positive euthanasia has come to refer to actions that actively cause death. The term passive euthanasia is used when certain common methods of treatment, such as antibiotics, drugs, or surgery, are withheld or a large quantity of needed but ultimately lethal pain medication is supplied. By the end of the 20th cent. passive euthanasia was said to be a common practice among U.S. hospitals and physicians. With regard to euthanasia in animals, there are strict rules and guidelines that ensure ethical euthanasia and disposal.

Much debate has occurred in the United States and other nations among physicians, religious leaders, lawyers, and the general public over the question of what constitutes actively causing death and what constitutes merely allowing death to occur naturally. The physician is faced with deciding whether measures used to keep patients alive are extraordinary in individual situations, e.g., whether a respirator or artificial kidney machine should be withdrawn from a terminally ill patient. The Supreme Court's decision in Cruzan v. Director, Missouri Dept. of Health set a precedent for the removal of life-support equipment from terminal cases.

Popular movements have supported the legalization of the living willliving will
or advance health care directive,
legal document in which a person expresses in advance his or her wishes concerning the use of artificial life support and other medical treatment should the person be unable to communicate such wishes due the effects of
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, a statement written by a mentally alert patient that can be used to express a wish to forgo artificial means to sustain life during terminal illness. In 1977, California became the first to pass a state law to this effect, known as the death-with-dignity statute. The absence of a written living will complicated the case of Terri Schiavo, a Florida woman who was in a persistent vegetative state from 1990 until 2005, when she died after having her feeding tube removed. In 2000 her husband, who was her legal guardian, won the right to remove it based upon what he stated were her orally expressed wishes, but legal challenges from her parents and Florida governor Jeb Bush and attempted government interventions through Florida and federal legislation delayed the tube's removal for five years. (See Schiavo caseSchiavo case,
the legal battles over the guardianship and rights of Theresa Maria Schindler Schiavo (1963–2005). Terri Schiavo was incapacitated and hospitalized in 1990, after she collapsed when her heart stopped beating due to a potassium imbalance, and her brain
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Societies advancing the cause of positive euthanasia were founded in 1935 in England and 1938 in the United States. End-of-Life Choices (formerly the Hemlock Society) is one controversial group that has pressed for right-to-die legislation on a national level. Positive euthanasia is for the most part illegal in the United States, but physicians may lawfully refuse to prolong life when there is extreme suffering.

In the early 1990s, Dr. Jack Kevorkian, a Michigan physician, gained notoriety by assisting a number of people to commit suicide and became the object of a state law (1992) forbidding such activity. Kevorkian, who had been tried and acquitted repeatedly in the assisted deaths of seriously ill people, was convicted of murder in Michigan in 1999 for an assisted suicide that was shown on national television. Meanwhile, in 1997, the Supreme Court upheld state laws banning assisted suicide (in most U.S. states assisting in a suicide is a crime).

In Oregon in 1994, voters approved physician-assisted suicide for some patients who are terminally ill (the patients must administer the drugs); the law went into effect in 1997, following a protracted court challenge. In 2001 the Bush administration sought to undermine the law with a directive issued under the federal Controlled Substances Act, but Oregon sued to prohibit the enforcement of it, and the Supreme Court ruled (2006) that the federal government had exceeded its authority. Similar measures have since been approved, by voters, legislators, or the courts, in Washington state (2008), Montana (2009), Vermont (2013), California (2015), Colorado and the District of Columbia (2016), and New Jersey and Maine (2019).

Since 1937 assisted suicide has not been illegal in Switzerland as long as the person who assists has no personal motive or gain. In 1993, the Netherlands decriminalized, under a set of restricted conditions, voluntary positive euthanasia (essentially, physician-assisted suicide) for the terminally ill, and in 2002 the country legalized physician-assisted suicide if voluntarily requested by seriously ill patients who face ongoing suffering. Belgium (2002), Luxembourg (2008), and some other nations and juridictions also have legalized physician-assisted suicide for certain patients who request it, and Canada's supreme court has overturned (2015) laws against physician-assisted suicide.

See also bioethicsbioethics,
in philosophy, a branch of ethics concerned with issues surrounding health care and the biological sciences. These issues include the morality of abortion, euthanasia, in vitro fertilization, and organ transplants (see transplantation, medical).
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See P. Singer, Rethinking Life and Death (1994); H. Hendin, Suicide in America (rev. ed. 1995). See also studies by J. Rachels (1986) and R. Wennberg (1989).

The Columbia Electronic Encyclopedia™ Copyright © 2013, Columbia University Press. Licensed from Columbia University Press. All rights reserved.


The act or practice of putting to death or allowing the death, in a relatively painless way, of persons or animals with incurable or painful disease.
McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The McGraw-Hill Companies, Inc.


the act of killing someone painlessly, esp to relieve suffering from an incurable illness
Collins Discovery Encyclopedia, 1st edition © HarperCollins Publishers 2005
References in periodicals archive ?
would eventually lead to involuntary euthanasia of the elderly.
The Nazi programme of active involuntary euthanasia targeted mentally incapacitated children.
(121) And, of course, he retained his original apprehensions about a slippery slope to nonvoluntary and involuntary euthanasia.
His letter stated: "Having carefully reviewed all the documentation you have sent me, I believe that involuntary euthanasia was performed on Mrs Gibbings.
This stands in contrast to rebuttals from some of the "nonpersons" whose lives would be at risk; the disability rights group Not Dead Yet protested Singer's appointment at Princeton, and Marcia Bristo, Chairperson of the National Council on Disability, said any proposed lessening of the rights of people with disabilities to establish a system of involuntary euthanasia amounts to "a defense of genocide" (Montgomery, 1999).
Because this directive would be carried out without further consideration of the patient's wishes once she reached that stage, this proposal ventures into the territory of nonvoluntary euthanasia, and possibly involuntary euthanasia (in cases where the now-incompetent Alzheimer's patient appears to be relatively content).
But SOS-NHS Patients in Danger, a group set up to oppose what it sees as "involuntary euthanasia in the NHS", accused the BMA of "legitimising" what was already taking place illegally in hospitals.
Over the course of these arguments, the right to die debate has centered primarily around the distinctions between active and passive euthanasia, and between voluntary and involuntary euthanasia. While it is recognised that other subcategories exist, such as assisted suicide, rational suicide, suicide, and homicide (Rogers, 1996), the distinction between active, passive, voluntary, and involuntary euthanasia remains the most important element in examining attitudes toward physician-assisted death (Sugarman, 1986).
Indeed, there is a real possibility that such matters as abortion, assisted suicide, involuntary euthanasia, sado-masochism and homosexual marriage will come to dominate discussions of public policy.
More startling was how quickly physicians had slipped down the slope to involuntary euthanasia, unilaterally terminating the lives of competent patients, as distinct from those who were "out of it" Remmelink reported more than 1,000 cases of death caused or hastened without any request from the patient.
Another division between groups is between those who approve only of voluntary euthanasia by competent consenting patients and those who accept involuntary euthanasia decisions made by surrogates for neonates or in cases of incompetency.
The most common non-religious argument against assisted suicide or voluntary euthanasia is that making such practices legal will inevitably lead to involuntary euthanasia. Seeing how assisted suicide measures operate in a few states over a period of several years should provide confirming evidence that medical and legal practitioners can and will distinguish between voluntary requests for assistance in dying and killing persons against their will.